22 Interesting Erythroblastosis Fetalis Facts

Hold on! No need to wear that worried look on your face. We are fully aware that you are kind of having a nightmare because of the weird name you see on the title. Guess what? Even, we had the same helpless look on our faces for the first time. But, as and when we kept on reading about Erythroblastosis Fetalis, we understood the concept and decided to pen down the same in the simplest possible language. So, here we are, writing about Erythroblastosis Fetalis facts. Just to give you a quick understanding, it is basically a disease that develops in fetuses because of an antibody present in mother’s bloodstream. It is a fatal disease but the fetus can survive with proper medical care but still, the newborn baby may have serious health complications. Are you ready?

Before we start, we will give a quick understanding of blood groups, antigens etc. to build the base for the article. Stay with us…

1. Our blood is made up of three types of cells viz., RBC (Red Blood Corpuscle), WBC (White Blood Corpuscle) and Thrombocytes. WBCs (also called as leukocytes) are called as the policemen of our body. Thrombocytes help in clotting the blood.

2. RBC which are also called as erythrocytes carry oxygen from lungs to other parts of the body and carry carbon dioxide from rest of the body to lungs. If we try to categorize blood into groups, then we have 4 major type of blood groups i.e., A, B, AB and O.

3. This categorization is possible because of the antigens present on the RBC’s surface. There are three types of antigens: A, B and O. A person will either have A, B, AB or O blood group depending on the genes which are inherited by him.

Here is a table which shows the blood group that a child will inherit from his / her parents:

Antigen Gene from Father

Antigen Gene from Mother

Antigen Gene in Offspring

A (A antigen, B antibody)

A (A antigen, B antibody)

A (A antigen, B antibody)

B (B antigen, A antibody)

B (B antigen, A antibody)

B (B antigen, A antibody)

O (no antigen, A, B antibodies)

O (no antigen, A, B antibodies)

O (no antigen, A, B antibodies)

A (A antigen, B antibody)

B (B antigen, A antibody)

AB (A,B antigens, no antibody)

A (A antigen, B antibody)

O (no antigen, A, B antibodies)

A (A antigen, B antibody)

B (B antigen, A antibody)

O (no antigen, A, B antibodies)

B (B antigen, A antibody)

4. There is another antigen gene called as Rh antigen gene. The name Rh is given because it was first found in Rhesus monkey (discovered by Karl Landsteiner). This Rh factor is important in knowing more about blood groups.

5. If even one copy of Rh+ is inherited from either of the parents, the offspring also carries an Rh antigen and is considered Rh+. If no copies are inherited, then the offspring has no Rh antigen and is considered Rh-.

6. This along with A, B and O antigens decide the blood group of a person which can be any one of the following: A+, A-, B+, B-, AB+, AB-, O+ and O-.

7. A person’s blood group is interlinked with his immunity system. The body’s immunity system will accept the blood group (if blood is introduced into bloodstream) which is the person’s specific blood group or another blood group which closely matches it.

8. If any other blood is transfused, then antibodies are created in the person who got blood transfusion and those antibodies kill the foreign antigens and sometimes it may become fatal.

9. Knowing the blood group of a woman when she is pregnant is very important. If the mother and the fetus has blood groups which are compatible, then there is no harm. But if the mother and fetus’ blood groups are not compatible, then the immunity system of mother’s body produces antibodies to kill the fetus’ RBC which are considered as foreign antigens.

10. There are two types of such incompatible diseases: Rh incompatibility disease and ABO incompatibility disease. Both diseases show almost similar symptoms but Rh incompatibility disease is more dangerous than ABO incompatibility disease. It is more dangerous because the Rh antibodies can traverse through placenta and kill the RBC of fetus.

11. Both of these incompatibility diseases don’t trouble when the woman is pregnant for the first time. During the delivery of the first child, the woman’s immunity system gets sensitized (comes in contact with foreign antigens and creates antibodies against it). When the woman gets pregnant again, if the blood groups of the fetus and mother are incompatible then starts the problem.

Erythroblastosis Fetalis Facts: 12-22

12. Here, we are going to discuss only about Rh incompatibility disease which is also called as Erythroblastosis fetalis. It has other names as well like immune hydrops fetalis or hemolytic disease of the newborn.

13. So when the mother’s immune system releases antibodies and those antibodies destroy RBC of fetus, the fetus develops anemia. To replenish the RBC, bone marrow of fetus produce erythroblasts (erythrocytes) which are immature.

14. Here the fetus body is overproducing erythroblasts which causes liver and spleen enlargement and may even lead to liver damage and spleen may get ruptured. Because the erythroblasts are being produced more, other blood cells like leukocytes and thrombocytes are produced less in number. Due to this, clotting of blood may become an issue.

15. When RBC die, they create a yellow substance called as bilurubin. Our body is used to certain amount of bilurubin in the blood and can’t take more than that. So, the bilurubin keeps on getting accumulated and causes jaundice (condition is called as hyperbilirubinemia) in babies which is pretty evident by seeing their yellow skin and eyes.

16. When left untreated, there is high risk that the baby gets Kernicterus. This is a condition where bilurubin gets accumulated in brain which causes permanent damage.

17. These are accompanied with high level of insulin and low glucose level in the blood. There are chances that a condition called hydrops fetalis may develop. It is a condition where body starts retaining fluid because of which the baby looks swollen. It causes breathing issues and if the condition prolongs then lung growth may be stunted and it may cause heart problems as well.

18. To diagnose this disease, one has to know the blood type of the woman. If she is Rh- and her husband is Rh+, then antibody screening is done to check whether the woman is sensitized (isoimmunity) or not. Indirect Coombs test is used mostly. If the baby is born and has the above said complication then to know the incompatibility, direct Coombs test is used.

19. Negative antibody titers are used but they are not highly reliable. When it is known that mother has developed antibodies against the fetus’ RBC, tests like percutaneous umbilical cord blood sampling (PUBS), Aminocentisis, ultrasound etc., are done regularly to check for the progress of fetus.

20. If bilurubin levels increase in the amniotic fluid or fetus’ blood or symptoms of hydrops fetalis are seen in ultrasound, then blood transfusions are done till the gestation period reaches 32-34 weeks. After that period, delivery will be performed. However, this happens only when there are high chances of intrauterine death.

21. After birth, the baby’s symptoms are carefully analyzed. The baby may be given some transfusions, undergo phototherapy (a treatment where the baby is kept under a yellow light which changes the shape of bilurubin which makes it easier to eliminate from the body), receive intravenous fluids and oxygen also.

22. But this disease has decreased to a large extent thanks to the advancement in medical field. However, when a baby is born with such symptoms, it may develop cerebral palsy or mental retardation. But with careful assessment, it may be treated.

Why on earth do you need my biography? I won't say it! Okay, a tiny bit won't hurt. I am technologically and geographically challenged but I love to read about random facts and hence... well, you are not that dumb, are you?